Electromechanical interference (EMI) poses a risk for patients with implanted cardiac rhythm-management devices. Most modern devices are highly unlikely to undergo inadvertent reprogramming due to EMI exposure. However, exposure to strong EMI could cause an electrical reset or false interpretation of battery life, potentially leading to a change in heart rate or pacemaker mode. Inappropriate delivery of high-energy tachyarrhythmia therapy (either antitachycardia pacing or shock) from a cardioverter-defibrillator can be associated with myocardial injury, as evidenced by troponin elevation or electrocardiographic changes consistent with injury.

The greatest source of EMI in the operating room is the electrosurgical unit. A monopolar electrosurgical unit set to a blended coagulation mode emits the greatest amount of EMI compared to other types and modes of use.

The electrosurgical dispersion pad should be placed so that the current path traveling from the handheld instrument to the unit (Figure 1) does not cross the...

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